Analysis of poisoning cases in children and adolescents hospitalized in public hospitals of the Republic of Srpska: A three-year retrospective study

Introduction: Poisonings among children and adolescents represent a significant global public health issue. Objective: To describe the demographic characteristics of hospitalized poisoning cases, analyze the causes and intent of poisoning, and examine their association with age and gender. Material and methods: A retrospective cross-sectional study included patients up to 19 years old hospitalized due to poisoning in public hospitals of Republika Srpska between 2018 and 2020. Data were collected from an electronic database and analyzed according to ICD-10 and ATC classifications. Statistical analysis included descriptive statistics, Chi-square, and Fisher’s exact tests (p<0.05). Results: A total of 188 poisoning cases were identified, with a mean age of 10.7 years. The highest proportion of poisonings was observed among adolescents aged 15 to 19 years (43.1%), while children aged 1 to 4 years accounted for 29.8% of cases. Unintentional poisonings constituted 60.6%, and intentional poisonings 39.4%, with intentional poisonings significantly more frequent among adolescents (p<0.001). The most common poisoning agents were medications (45.7%), especially among children aged 1 to 4 years (62.5%), while soaps and detergents dominated in children under one year. Girls more frequently experienced intentional poisonings (51.0%) with medications, whereas boys predominantly had unintentional poisonings (73.9%), most commonly involving alcohol (p<0.001 and p=0.005). According to ICD-10, the most frequently used medications were antiepileptics, sedativehypnotics, and antiparkinsonian drugs (44.2%), while ATC classification showed that nervous system drugs accounted for 59.3% of poisonings, especially in the adolescent population (p<0.001). Conclusion: Unintentional medication poisonings predominate in younger children, while intentional poisonings are more common among adolescents, with medications being dominant in girls and alcohol in boys. These findings highlight the need for age- and gender-specific prevention strategies.